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Even modest consumer contributions, when designed appropriately, can
positively influence how members think about and access health care,
according to a new white paper

INDIANAPOLIS–(BUSINESS WIRE)–Indiana residents who are paying for their health care benefits under
the state’s novel approach to Medicaid are accessing more preventive
services, following up on care more and using the ER for non-emergency
treatment less than members in traditional Medicaid plans, according to
a new
white paper by Anthem, Inc.’s Public Policy Institute.

The early success from Healthy Indiana Plan (HIP) 2.0 with respect to
members’ engagement in their health care runs contrary to long-held
assumptions that these types of financial incentives won’t motivate
Medicaid members. In fact, members are overwhelmingly satisfied with
their health care in spite of contributing to a monthly savings account,
according to the study.

“Although this model is still relatively new in Medicaid, Indiana is
demonstrating the ways in which alternative approaches to Medicaid
expansion can provide positive outcomes for both the member and the
state,” said Kristen Metzger, president of Anthem’s Medicaid health plan
in Indiana. Anthem’s affiliated health plan is one of three private
insurers offering coverage under HIP 2.0, and the data for the white
paper was taken primarily from the Anthem plan’s member claims and
member research.

HIP 2.0, which began in February 2015 and covers around 387,000
individuals, offers a unique approach to Medicaid benefits under a
waiver agreement between the state of Indiana and the federal Centers
for Medicare & Medicaid Services. HIP 2.0 offers two major benefit
plans: Basic and Plus; both include all required essential health
benefits. Plus also includes dental and vision benefits, higher service
limits, and a comprehensive drug benefit, and requires members to make a
monthly contribution based on their income to their POWER accounts.
Basic does not, but does require cost sharing at the time of service for
most services.

One of the most revealing findings is that members who pay for Plus –
which requires a monthly contribution — are accessing their benefits,
engaging in their care, and seeking care in the most appropriate setting
at higher rates than are Basic or traditional Medicaid members. For
example:

The percentage of members who received preventive health screenings,
such as screenings for breast cancer and cervical cancer, is higher
for Plus versus Basic members. Roughly 39 percent of Plus members
received a breast cancer screening (compared to 21 percent of Basic
members) while 27 percent of Plus members obtained a cervical cancer
screening (compared to 15 percent of Basic members).1

Plus members are also more likely to follow up on care, with 77
percent of Plus members obtaining appropriate follow-up care for use
of an ACE inhibitor, compared to only 66 percent of members in Basic.2

ER use among Plus members is 21 percent lower than ER use among Basic
members.3 Plus members have no cost sharing at the time of
service except for CMS-allowable co-payments for non-emergency ER use,
which range from $8 to $25.

ER use among HIP members is substantially lower than ER use among
enrollees in Hoosier Healthwise (Indiana’s traditional Medicaid
program). HEDIS data show that members who transitioned to HIP from
Hoosier Healthwise have 30 percent lower ER utilization compared to ER
use while enrolled in traditional Medicaid, resulting in an estimated
savings of about $2.5 million.4

Additionally, an overwhelming number of HIP members – nearly 90 percent
– are satisfied with their overall health care, according to the
Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey.

“Early observations of HIP 2.0 suggest that increased ownership of one’s
health care has a positive impact on how members engage in their care,”
said Jennifer Kowalski, vice president at Anthem’s Public Policy
Institute. “This experience adds to the narrative of positive outcomes
from approaches that utilize consumer engagement to drive healthier
behaviors. It also suggests that even modest member contributions such
as those required under HIP Plus, when designed appropriately, can
positively influence how members think about and access care.”

The Anthem Public Policy Institute was established to share data and
insights to inform public policy and shape the health care programs of
the future. The Public Policy Institute strives to be an objective and
credible contributor to health care innovation and transformation
through publication of policy-relevant data analysis, timely research
and insights from innovative programs.

About Anthem, Inc.

Anthem (NYSE:ANTM) is working to transform health care with trusted and
caring solutions. Our health plan companies deliver quality products and
services that give their members access to the care they need. With over
72 million people served by its affiliated companies, including more
than 39 million enrolled in its family of health plans, Anthem is one of
the nation’s leading health benefits companies. For more information
about Anthem’s family of companies, please visit www.antheminc.com/companies.

1 Data comes from Anthem Insurance Companies, Inc. (February
12, 2016) and represents the period of February 1, 2015 through
September 30, 2015.

2 Data comes from Anthem Insurance Companies, Inc. (February
12, 2016) and represents the period of February 1, 2015 through
September 30, 2015.

3 Data comes from Anthem Insurance Companies, Inc. (February
12, 2016) and represents the period of February 1, 2015 through
September 30, 2015.

4 Data comes from Anthem Insurance Companies, Inc. (February
12, 2016) and represents the period of February 1, 2015 through
September 30, 2015.